Chapter IV: Preface (4)

A capability of attaining old age is very often handed down from one generation to another, and heredity is probably the most powerful factor in connection with longevity. A necessary condition of reaching advanced age is the possession of sound bodily organs, and such an endowment is eminently capable of transmission. Instances of longevity characterizing several generations are frequently brought to notice. A recent and most interesting example of transmitted longevity is that of the veteran guardian of the public health, Sir Edwin Chadwick, who was entertained at a public dinner a few weeks ago on the occasion of his reaching his ninetieth year. He informed his entertainers that his father died at the age of eighty-four, one of his grandfathers at ninety-five, and that two more remote ancestors were centenarians.

It is difficult to estimate the influence of other contingencies which affect longevity. With regard to sex, Hufeland's opinion was that women were more likely than men to become old, but that instances of extreme longevity were more frequent among men. This opinion is to some extent borne out by Dr. Humphry's statistics: of fifty-two centenarians, thirty-six were women. Marriage would appear to be conducive to longevity. A well-known French _savant_, Dr. Bertillon, states that a bachelor of twenty-five is not a better life than a married man of forty-five, and he attributes the difference in favour of married people to the fact that they take more care of themselves, and lead more regular lives than those who have no such tie. It must, however, be remembered that the mere fact of marrying indicates superior vitality and vigour, and the ranks of the unmarried are largely filled by the physically unfit.

In considering occupations as they are likely to effect longevity, those which obviously tend to shorten life need not be considered. With respect to the learned professions, it would appear that among the clergy the average of life is beyond that of any similar class. It is improbable that this average will be maintained for the future; the duties and anxieties imposed upon the clergy of the present generation place them in a very different position from that of their predecessors. Among lawyers there have been several eminent judges who attained a great age, and the rank and file of the profession are also characterized by a decided tendency to longevity. The medical profession supplies but few instances of extreme old age, and the average duration of life among its members is decidedly low, a fact which can be easily accounted for. Broken rest, hard work, anxieties, exposure to weather and to the risks of infection can not fail to exert an injurious influence upon health. No definite conclusions can be arrived at with regard to the average longevity of literary and scientific men, but it might be supposed that those among them who are not harassed by anxieties and enjoy fair health would probably reach old age. As a general rule, the duration of life is not shortened by literary pursuits. A man may worry himself to death over his books, or, when tired of them, may seek recreation in pursuits destructive to health; but application to literary work tends to produce cheerfulness, and to prolong rather than shorten the life even of an infirm man. In Prof. Humphry's "Report on Aged Persons," containing an account of eight hundred and twenty-four individuals of both sexes, and between the ages of eighty and one hundred, it is stated that forty-eight per cent. were poor, forty-two per cent. were in comfortable circumstances, and only ten per cent. were described as being in affluent circumstances. Dr. Humphry points out that these ratios "must not be regarded as representing the relations of poverty and affluence to longevity, because, in the first place, the poor at all ages and in all districts bear a large proportion to the affluent; and, secondly, the returns are largely made from the lower and middle classes, and in many instances from the inmates of union work-houses, where a good number of aged people are found." It must also be noticed that the "past life-history" of these individuals showed that the greater proportion (fifty-five per cent.) "had lived in comfortable circumstances," and that only thirty-five per cent. had been poor.

Merely to enumerate the causes to which longevity has been attributed in attempting to account for individual cases would be a task of some magnitude; it will be sufficient to mention a few somewhat probable theories. Moderation in eating and drinking is often declared to be a cause of longevity, and the assertion is fully corroborated by Dr. Humphry's inquiries. Of his fifty-two centenarians, twelve were recorded as total abstainers from alcoholic drinks throughout life, or for long periods; twenty had taken very little alcohol; eight were reported as moderate in their use of it; and only three habitually indulged in it. It is quite true that a few persons who must be classified as drunkards live to be very old; but these are exceptions to the general rule, and such cases appear to be more frequent than they really are, because they are often brought to notice by those who find encouragement from such examples. The habit of temperance in food, good powers of digestion, and soundness of sleep are other main characteristics of most of those who attain advanced years, and may be regarded as causes of longevity. Not a few old persons are found on inquiry to take credit to themselves for their own condition, and to attribute it to some remarkable peculiarity in their habits or mode of life. It is said that Lord Mansfield, who reached the age of eighty-nine, was wont to inquire into the habits of life of all aged witnesses who appeared before him, and that only in one habit, namely, that of early rising, was there any general concurrence. Health is doubtless often promoted by early rising, but the habit is not necessarily conducive to longevity. It is, as Sir H. Holland points out, more probable that the vigour of the individuals maintains the habit than that the latter alone maintains the vitality.

If we pass from probable to improbable causes of longevity we are confronted by many extravagant assumptions. Thus, to take only a few examples, the immoderate use of sugar has been regarded not only as a panacea, but as decidedly conducive to length of days. Dr. Slare, a physician of the last century, has recorded the case of a centenarian who used to mix sugar with all his food, and the doctor himself was so convinced of the "balsamic virtue" of this substance that he adopted the practice, and boasted of his health and strength in his old age. Another member of the same profession used to take daily doses of tannin (the substance employed to harden and preserve leather), under the impression that the tissues of the body would be thereby protected from decay. His life was protracted beyond the ordinary span, but it is questionable whether the tannin acted in the desired direction. Lord Combermere thought that his good health and advanced years were due, in part at least, to the fact that he always wore a tight belt round his waist. His lordship's appetite was doubtless thereby kept within bounds; we are further told that he was very moderate in the use of all fluids as drink. Cleanliness might be supposed to aid in prolonging life, yet a Mrs. Lewson, who died in the early part of this century, aged one hundred and six, must have been a singularly dirty person. We are told that instead of washing she smeared her face with lard, and asserted that "people who washed always caught cold." This lady, no doubt, was fully persuaded that she had discovered the universal medicine.

Many of the alchemists attributed the power of prolonging life to certain preparations of gold, probably under the idea that the permanence of the metal might be imparted to the human system. Descartes is said to have favoured such opinions; he told Sir Kenelm Digby that, although he would not venture to promise immortality, he was certain that his life might be lengthened to the period of that enjoyed by the patriarchs. His plan, however, seems to have been the very rational and simple one of checking all excesses and enjoining punctual and frugal meals.

Having thus endeavoured to show the extent to which human life may be prolonged, and having examined some of the causes or antecedents of longevity, the last subject for inquiry is the means by which it may be attained. Certain preliminary conditions are obviously requisite; in the first place there must be a sound constitution derived from healthy ancestors, and in the second there must be a freedom from organic disease of important organs. Given an individual who has reached the grand climacteric, or threescore and ten, and in whom these two conditions are fulfilled, the means best adapted to maintain and prolong his life constitute the question to be solved. It has been said that "he who would long to be an old man must begin early to be one," but very few persons designedly take measures in early life in order that they may live longer than their fellows.

The whole term of life may be divided into the three main periods of growth and development, of maturity, and of decline. No hard and fast line can be drawn between these two latter phases of existence: the one should pass gradually into the other until the entire picture is changed. Diminished conservative power and the consequent triumph of disintegrating forces are the prominent features of the third period, which begins at different times in different individuals, its advent being mainly controlled by the general course of the preceding years. The "turning period," also known as the "climacteric" or "middle age," lies between forty-five and sixty; the period beyond may be considered as belonging to advanced life or old age. The majority of the changes characteristic of these last stages are easily recognizable. It is hardly necessary to mention the wrinkled skin, the furrowed face, the "crow's feet" beneath the eyes, the stooping gait, and the wasting of the frame. The senses, notably vision and hearing, become less acute; the power of digestion is lessened; the force of the heart is diminished; the lungs are less permeable; many of the air-cells lose their elasticity and merge into each other, so that there is less breathing surface as well as less power. Simultaneously with these changes the mind may present signs of enfeeblement; but in many instances its powers long remain in marked contrast with those of the body. One fact connected with advanced life is too often neglected. It should never be forgotten that while the "forces in use" at that period are easily exhausted, the "forces in reserve" are often so slight as to be unable to meet the smallest demand. In youth, the reserve powers are superabundant; in advanced life, they are reduced to a minimum, and in some instances are practically non-existent. The recognition of this difference is an all-important guide in laying down rules for conduct in old age.

In order to prolong life and at the same time to enjoy it, occupation of some kind is absolutely necessary; it is a great mistake to suppose that idleness is conducive to longevity. It is at all times better to wear out than to rust out, and the latter process is apt to be speedily accomplished. Every one must have met with individuals who, while fully occupied till sixty or even seventy years of age, remained hale and strong, but aged with marvelous rapidity after relinquishing work, a change in their mental condition becoming especially prominent. There is an obvious lesson to be learned from such instances, but certain qualifications are necessary in order to apply it properly. With regard to mental activity, there is abundant evidence that the more the intellectual faculties are exercised the greater the probability of their lasting. They often become stronger after the vital force has passed its culminating point; and this retention of mental power is the true compensation for the decline in bodily strength. Did space permit, many illustrations could be adduced to show that the power of the mind can be preserved almost unimpaired to the most advanced age. Even memory, the failure of which is sometimes regarded as a necessary concomitant of old age, is not infrequently preserved almost up to the end of life. All persons of middle age should take special pains to keep the faculties and energies of the mind in a vigorous condition; they should not simply drift on in a haphazard fashion, but should seek and find pleasure in the attainment of definite objects. Even if the mind has not been especially cultivated, or received any decided bent, there is at the present day no lack of subjects on which it can be agreeably and profitably exercised. Many sciences which, twenty or thirty years ago, were accessible only to the few, and wore at best a somewhat uninviting garb, have been rendered not merely intelligible but even attractive to the many; and in the domain of general literature the difficulty of making a choice among the host of allurements is the only ground for complaint. To increase the taste for these and kindred subjects is worth a considerable effort, if such be necessary; but the appetite will generally come with the eating. The possession of some reasonable hobby which can be cultivated indoors is a great advantage in old age, and there are many pursuits of this character besides those connected with literature and science. Talleyrand laid great stress on a knowledge of whist as indispensable to a happy old age, and doubtless to many old people that particular game affords not only recreation but a pleasant exercise to the mind. It is, however, an unworthy substitute for higher objects, and should be regarded only as an amusement and not as an occupation.

Whatever be the sphere of mental activity, no kind of strain must be put upon the mind by a person who has reached sixty-five or seventy years. The feeling that mental power is less than it once was not infrequently stimulates a man to increased exertions which may provoke structural changes in the brain, and will certainly accelerate the progress of any that may exist in that organ. When a man finds that a great effort is required to accomplish any mental task that was once easy, he should desist from the attempt, and regulate his work according to his power. With this limitation, it may be taken for granted that the mental faculties will be far better preserved by their exercise than by their disuse.

Somewhat different advice must be given with regard to bodily exercises in their reference to longevity. Exercise is essential to the preservation of health; inactivity is a potent cause of wasting and degeneration. The vigour and equality of the circulation, the functions of the skin, and the aeration of the blood, are all promoted by muscular activity, which thus keeps up a proper balance and relation between the important organs of the body. In youth, the vigour of the system is often so great that if one organ be sluggish another part will make amends for the deficiency by acting vicariously, and without any consequent damage to itself. In old age, the tasks can not be thus shifted from one organ to another; the work allotted to each sufficiently taxes its strength, and vicarious action can not be performed without mischief. Hence the importance of maintaining, as far as possible, the equable action of all the bodily organs, so that the share of the vital processes assigned to each shall be properly accomplished. For this reason exercise is an important part of the conduct of life in old age; but discretion is absolutely necessary. An old man should discover by experience how much exercise he can take without exhausting his powers, and should be careful never to exceed the limit. Old persons are apt to forget that their staying powers are much less than they once were, and that, while a walk of two or three miles may prove easy and pleasurable, the addition of a return journey of similar length will seriously overtax the strength. Above all things, sudden and rapid exertion should be scrupulously avoided by persons of advanced age. The machine which might go on working for years at a gentle pace often breaks down altogether when its movements are suddenly accelerated. These cautions may appear superfluous, but instances in which their disregard is followed by very serious consequences are by no means infrequent.

No fixed rule can be laid down as to the kind of exercise most suitable for advanced age. Much must depend upon individual circumstances and peculiarities; but walking in the open air should always be kept up and practiced daily, except in unfavourable weather. Walking is a natural form of exercise and subserves many important purposes: not a few old people owe the maintenance of their health and vigour to their daily "constitutional." Riding is an excellent form of exercise, but available only by a few; the habit, if acquired in early life, should be kept up as long as possible, subject to the caution already given as to violent exercise. Old persons of both sexes fond of gardening, and so situated that they may gratify their tastes, are much to be envied. Body and mind are alike exercised by what Lord Bacon justly termed "the purest of human pleasures." Dr. Parkes goes so far as to say that light garden or agricultural work is a very good exercise for men past seventy: "It calls into play the muscles of the abdomen and back, which in old men are often but little used, and the work is so varied that no muscle is kept long in action." A few remarks must be made, in conclusion, with regard to a new form of exercise sometimes indulged in even by elderly men. I allude to so-called "tricycling." Exhilarating and pleasant as it may be to glide over the ground with comparatively little effort, the exercise is fraught with danger for men who have passed the grand climacteric. The temptation to make a spurt must be often irresistible; hills must be encountered, some perhaps so smooth and gradual as to require no special exertion, none, at least, that is noticed in the triumph of surmounting them. Now, if the heart and lungs be perfectly sound, such exercises may be practiced for some time with _apparent_ impunity; but if (as is very likely to be the case) these organs be not quite structurally perfect, even the slightest changes will, under such excitement, rapidly progress and lead to very serious results. Exercise unsuited to the state of the system will assuredly not tend to the prolongation of life.

With regard to food, we find from Dr. Humphry's report that ninety per cent. of the aged persons were either "moderate" or "small" eaters, and such moderation is quite in accord with the teachings of physiology. In old age the changes in the bodily tissues gradually become less and less active, and less food is required to make up for the daily waste. The appetite and the power of digestion are correspondingly diminished, and although for the attainment of a great age a considerable amount of digestive power is absolutely necessary, its perfection, when exercised upon proper articles of diet, is the most important characteristic. Indulgence in the pleasures of the table is one of the common errors of advanced life, and is not infrequent in persons who, up to that period, were moderate or even small eaters. Luxuries in the way of food are apt to be regarded as rewards that have been fully earned by a life of labour, and may, therefore, be lawfully enjoyed. Hence arise many of the evils and troubles of old age, and notably indigestion and gouty symptoms in various forms, besides mental discomfort. No hard and fast rules can be laid down, but strict moderation should be the guiding maxim. The diet suitable for most aged persons is that which contains much nutritive material in a small bulk, and its quantity should be in proportion to the appetite and power of digestion. Animal food, well cooked, should be taken sparingly and not more often than twice a day, except under special circumstances. Dr. Parkes advocates rice as a partial substitute for meat when the latter is found to disagree with old persons. "Its starch-grains are very digestible, and it supplies nitrogen in moderate amount, well fitted to the worn and slowly repaired tissues of the aged." Its bulk, however, is sometimes a disadvantage; in small quantities it is a valuable addition to milk and to stewed fruits.

The amount of food taken should be divided between three or four meals at fairly regular intervals. A sense of fullness or oppression after eating ought not to be disregarded. It indicates that the food taken has been either too abundant or of improper quality. For many elderly people the most suitable time for the principal meal is between 1 and 2 P. M. As the day advances the digestive powers become less, and even a moderately substantial meal taken in the evening may seriously overtask them. Undigested food is a potent cause of disturbed sleep, an evil often very troublesome to old people, and one which ought to be carefully guarded against.

It is an easier task to lay down rules with regard to the use of alcoholic liquors by elderly people. The Collective Investigation Committee of the British Medical Association has lately issued a "Report on the Connection of Disease with Habits of Intemperance," and two at least of the conclusions arrived at are worth quoting: "Habitual indulgence in alcoholic liquors, beyond the most moderate amount, has a distinct tendency to shorten life, the average shortening being roughly proportional to the degree of indulgence. Total abstinence and habitual temperance augment considerably the chance of death from old age or natural decay, without special pathological lesion." Subject, however, to a few exceptions, it is not advisable that a man sixty-five or seventy years of age, who has taken alcohol in moderation all his life, should suddenly become an abstainer. Old age can not readily accommodate itself to changes of any kind, and to many old people a little good wine with their meals is a source of great comfort. To quote again from Ecclesiasticus, "Wine is as good as life to a man, if it be drunk moderately, for it was made to make men glad." Elderly persons, particularly at the close of the day, often find that their nervous energy is exhausted, and require a little stimulant to induce them to take a necessary supply of proper nourishment, and perhaps to aid the digestive powers to convert their food to a useful purpose. In the debility of old age, and especially when sleeplessness is accompanied by slow and imperfect digestion, a small quantity of a generous and potent wine, containing much ether, often does good service. Even a little beer improves digestion in some old people; others find that spirits, largely diluted, fulfill the same purpose. Individual peculiarities must be allowed for; the only general rule is that which prescribes strict moderation.

It is not to be inferred from the hints given in the preceding paragraphs that the preservation of health should be the predominant thought in the minds of elderly persons who desire that their lives should be prolonged. To be always guarding against disease, and to live in a state of constant fear and watchfulness, would make existence miserable and hasten the progress of decay. Selfish and undue solicitude with regard to health not only fails to attain its object, but is apt to induce that diseased condition of mind known as hypochondriasis, ["the blues,"] the victims of which are always a burden and a nuisance, if not to themselves, at least to all connected with them. Addison, in the _Spectator_, after describing the valetudinarian who constantly weighed himself and his food, and yet became sick and languishing, aptly remarks, "A continual anxiety for life vitiates all the relishes of it, and casts a gloom over the whole face of nature, as it is impossible that we should take delight in anything that we are every moment afraid of losing."

Sleep is closely connected with the question of diet; "good sleeping" was a noticeable feature in the large majority of Dr. Humphry's cases. Sound, refreshing sleep is of the utmost consequence to the health of the body, and no substitute can be found for it as a restorer of vital energy. Sleeplessness is, however, often a source of great trouble to elderly people, and one which is not easily relieved. Narcotic remedies are generally mischievous; their first effects may be pleasant, but the habit of depending upon them rapidly grows until they become indispensable. When this stage has been reached, the sufferer is in a far worse plight than before. In all cases the endeavour should be made to discover whether the sleeplessness be due to any removable cause--such as indigestion, cold, want of exercise, and the like. In regard to sleeping in the daytime, there is something to be said both for and against that practice. A nap of "forty winks" in the afternoon enables many aged people to get through the rest of the day in comfort, whereas they feel tired and weak when deprived of this refreshment. If they rest well at night there can be no objection to the afternoon nap; but if sleeplessness be complained of, the latter should be discontinued for a time. Most old people find that a reclining posture, with the feet and legs raised, is better than the horizontal position for the afternoon nap. Digestion proceeds with more ease than when the body is recumbent.

Warmth is very important for the aged; exposure to chills should be scrupulously avoided. Bronchitis is the malady most to be feared, and its attacks are very easily provoked. Many old people suffer from more or less cough during the winter months, and this symptom may recur year after year, and be almost unheeded. At last, perhaps a few minutes' exposure to a cold wind increases the irritation in the lungs, the cough becomes worse, and the difficulty of breathing increases until suffocation terminates in death. To obviate such risk the skin should be carefully protected by warm flannel clothes, the outdoor thermometer should be noticed and winter garments should always be at hand. In cold weather the lungs should be protected by breathing through the nose as much as possible, and by wearing a light woolen or silken muffler over the mouth. The temperature of the sitting and bed-rooms is another point which requires attention. Some old people pride themselves on never requiring a fire in their bed-rooms. It is, however, a risky practice to exchange a temperature of 65° or 70° for one fifteen or twenty degrees lower. As a general rule, for persons sixty-five years of age and upward, the temperature of the bed-room should not be below 60°, and when there are any symptoms of bronchitis it should be raised from five to ten degrees higher.

Careful cleansing of the skin is the last point which needs to be mentioned in an article like the present. Attention to cleanliness is decidedly conducive to longevity, and we may congratulate ourselves on the general improvement in our habits in this respect. Frequent washing with warm water is very advantageous for old people, in whom the skin is only too apt to become hard and dry; and the benefit will be increased if the ablutions be succeeded by friction with coarse flannel or linen gloves, or with a flesh-brush. Every part of the skin should be thus washed and rubbed daily. The friction removes worn-out particles of the skin, and the exercise promotes warmth and excites perspiration. Too much attention can hardly be paid to the state of the skin; the comfort of the aged is greatly dependent upon the proper discharge of its functions.

Such, then, are the principal measures by which life may be prolonged and health maintained down to the closing scene. It remains to be seen whether, as a result of progress of knowledge and civilization, life will ever be protracted beyond the limit assigned to it in a preceding paragraph. There is no doubt that the _average duration_ of human life is capable of very great extension, and that the same causes which serve to prolong life materially contribute toward the happiness of mankind. The experience of the last few decades abundantly testifies to the marked improvement which has taken place in the public health. Statistics show that at the end of the septennial period, 1881-'87, 400,000 persons were alive in England and Wales whose death would have taken place had the mortality been in the same proportion as during the previous decade. It may be reasonably expected that as time goes on there will be an increase in the proportion of centenarians to the population as a whole.

The question whether long life is, after all, desirable does not admit of any general answer. Much depends upon the previous history of the individual, and his bodily and mental condition. The last stages of a well spent life may be the happiest, the shuffling-off of the mortal coil, though calmly expected, need not be wished for. The picture afforded by cheerful and mellow old age is a lesson to younger generations. Elderly people may, if they choose, become centers of improving and refining influence. On the other hand, old age can not be regarded as a blessing when it is accompanied by profound decrepitude and disorder of mind and body. Senile dementia, or second childishness, is, of all conditions, perhaps the most miserable, though not so painful to the sufferer as to those who surround him. Its advent may be accelerated by ignorance and neglect, and almost assuredly retarded or prevented by such simple measures as have been suggested. No one who has had opportunities of studying old people can shut his eyes to the fact that many of the incapabilities of age may be prevented by attention to a few simple rules, the observance of which will not only prolong life and make it happier and more comfortable, but will reduce to a minimum the period of decrepitude. Old age may be an incurable disease, admitting of but one termination, but the manner of that end, and the condition which precedes it, are, though not altogether, certainly to a very great extent, within our own power.

NATURAL LIFE AND DEATH: AND RULES FOR HEALTH

BENJAMIN WARD RICHARDSON, M.D.

[Dr. Richardson was an English physician of uncommon
originality and ability. He founded and for some years edited
the _Journal of Public Health_, chiefly directed toward the
prevention of disease. In 1875 he created widespread interest
by sketching an imaginary "Model City of Health" to be called
Hygeia. He wrote several important books; from "The Diseases
of Modern Life," published by D. Appleton & Co., New York,
are taken the extracts which follow.]

By the strict law of Nature a man should die as unconscious of his death as of his birth.

Subjected at birth to what would be, in the after-conscious state, an ordeal to which the most cruel of deaths were not possibly more severe, he sleeps through the process, and only upon the subsequent awakening feels the impressions, painful or pleasant, of the world into which he is delivered. In this instance the perfect law is fulfilled because the carrying of it out is retained by Nature herself: human free-will and the caprice that springs from it have no influence.

By the hand of Nature death were equally a painless portion. The cycle of life completed, the living being sleeps into death when Nature has her way.

This purely painless process, this descent by oblivious trance into oblivion, this natural physical death, is the true Euthanasia; and it is the duty of those we call physicians to secure for man such good health as shall bear him in activity and happiness onward in his course to this goal. For Euthanasia, though it be open to every one born of every race, is not to be had by any save through obedience to those laws which it is the mission of the physician to learn, to teach, and to enforce. Euthanasia is the sequel of health, the happy death engrafted on the perfect life.

When the physician has taught the world how this benign process of Nature may be secured, and the world has accepted the lesson, death itself will be practically banished; it will be divested equally of fear, of sorrow, of suffering. It will come as a sleep.

If you ask me what proof there is of the possibility of such a consummation, I point to our knowledge of the natural phenomena of one form of dissolution revealed to us even now in perfect, though exceptional, illustration. We have all seen Nature, in rare instances, vindicating herself despite the social opposition to her, and showing how tenderly, how soothingly, how like a mother with her foot on the cradle, she would, if she were permitted, rock us all gently out of the world. How, if the free-will with which she has armed us were brought into accord with her designs, she would give us the riches, the beauties, the wonders of the Universe for our portion so long as we could receive and enjoy them; and at last would gently withdraw us from them, sense by sense, with such imperception that the pain of the withdrawal would be unfelt and indeed unknown.

Ten times in my own observation I remember witnessing, with attentive mind, these phenomena of natural Euthanasia. Without pain, anger, or sorrow, the intellectual faculties of the fated man lose their brightness. Ambition ceases, or sinks into desire for repose. Idea of time, of space, of duty, lingeringly pass away. To sleep and not to dream is the pressing and, step by step, still pressing need; until at length it whiles away nearly all the hours. The awakenings are shorter and shorter; painless, careless, happy awakenings to the hum of a busy world, to the merry sounds of children at play, to the sound of voices offering aid; to the effort of talking on simple topics and recalling events that have dwelt longest on the memory; and then again the overpowering sleep. Thus on and on, until at length, the intellectual nature lost, the instinctive and merely animal functions, now no longer required to sustain the higher faculties, in their turn succumb and fall into inertia.

This is death by Nature, and when mankind has learned the truth, when the time shall come--as come it will--that "there shall be no more an infant of days, nor an old man who hath not filled his days," this act of death, now, as a rule, so dreaded because so premature, shall, arriving only at its appointed hour, suggest no terror, inflict no agony.

The sharpness of death removed from those who die, the poignancy of grief would be almost equally removed from those who survive, were natural Euthanasia the prevailing fact. Our sensibilities are governed by the observance of natural law and the breach of it. It is only when nature is vehemently interrupted that we either wonder or weep. Thus the old Greeks, fathers of true mirth, who looked upon prolonged grief as an offence, and attached the word madness to melancholy,--even they were so far imbued with sorrow when the child or the youth died, that they bore the lifeless body to the pyre in the break of the morning, lest the sun should behold so sad a sight as the young dead; while we, who court rather than seek to dismiss melancholy, who find poetry and piety in melancholic reverie, and who indulge too often in what, after a time, becomes the luxury of woe, experience a gradation of suffering as we witness the work of death. For the loss of the child and the youth we mourn in the perfect purity of sorrow; for the loss of the man in his activity we feel grief mingled with selfish regret that so much that was useful has ceased to be. In the loss of the aged, in their days of second childishness and mere oblivion, we sympathize for something that has passed away, and for a moment recall events saddening to the memory; but how soon this consoling thought succeeds and conquers--that the race of the life that has gone was run, and that for its own sake the dispensation of its removal was most merciful and most wise.

To the rule of natural death there are a few exceptions. Unswerving in her great purpose for the universal good, Nature has imposed on the world of life her storms, earthquakes, lightnings, and all those sublime manifestations of her supreme power which, in the infant days of the universe, cowed the boldest and implanted in the human heart fears and superstitions which in hereditary progression have passed down even to the present generations. Thus she has exposed us all to accidents of premature death, but, with infinite wisdom, and as if to tell us that her design is to provide for these inevitable calamities, she has given a preponderance of number at birth to those of her children who by reason of masculine strength and courage shall have most frequently to face her elements of destruction. Further, she has provided that death by her, by accidental collision with herself shall, from its very quickness, be freed of pain. For pain is a product of time. To experience pain the impression producing it must be transmitted from the injured part of the living body to the conscious centre, must be received at the conscious centre, and must be recognized by the mind as a reception; the last act in truth being the conscious act. In the great majority of deaths from natural accidents there is not sufficient time for the accomplishment of these progressive steps by which the consciousness is reached. The unconsciousness of existence is the first and last fact inflicted upon the stricken organism: the destruction is so mighty, that the sense of it is not revealed.

The duration of time intended by Nature to extend between the birth of the individual and his natural Euthanasia is undetermined, except in an approximate degree. From the first, the steady, stealthy attraction of the earth is ever telling upon the living body. Some force liberated from the body during life enables it, by self-controlled resistance, to overcome its own weight. For a given part of its cycle the force produced is so efficient, that the body grows as well as moves by its agency against weight; but this special stage is limited to an extreme, say, of thirty years. There is then another period, limited probably also to thirty years, during which the living structure in its full development maintains its resistance to its weight. Finally, there comes a time when this resistance begins to fail, so that the earth, which never for a moment loses her grasp, commences and continues to prevail, and after a struggle, extended from twenty to thirty years, conquers, bringing the exhausted organism which has daily approached nearer and nearer to her dead self, into her dead bosom.

Why the excess of power developed during growth or ascent of life should be limited as to time; why the power that maintains the developed body on the level plain should be limited as to time; why the power should decline so that the earth should be allowed to prevail and bring descent of life, are problems as yet unsolved. We call the force that resists the earth Vital. We say it resists death; we speak of it as stronger in the young than in the old; but we know nothing more of it really, from a physical point of view, than that while it exists it opposes terrestrial weight sufficiently to enable the body to move with freedom on the surface of the earth.

These facts we accept as ultimate facts. To say that the animal is at birth endowed with some reserve force, something over and above what it obtains from food and air, would seem a reasonable conclusion; but we have no proofs that it is true, save that the young resist better than the old. We must therefore rest content with our knowledge in its simple form, gathering from it the lesson that death, a part of the scheme of life, is ordained upon a natural term of life, is beneficially planned, "is rounded with a sleep."

[Then follow chapters on disease, leading up to rules for health.]

RULES FOR HEALTH